An adsorbate biased dynamic 3D porous framework for inverse CO2 sieving over C2H2.

Separating carbon dioxide (CO2) from acetylene (C2H2) is one of the most critical and complex industrial separations due to similarities in physicochemical properties and molecular dimensions. Herein, we report a novel Ni-based three-dimensional framework {[Ni4(µ3-OH)2(µ2-OH2)2(1,4-ndc)3](3H2O)}n (1,4-ndc = 1,4-naphthalenedicarboxylate) with a one-dimensional pore channel (3.05 × 3.57 Å2), that perfectly matches with the molecular size of CO2 and C2H2. The dehydrated framework shows structural transformation, decorated with an unsaturated Ni(ii) centre and pendant oxygen atoms. The dynamic nature of the framework is evident by displaying a multistep gate opening type CO2 adsorption at 195, 273, and 298 K, but not for C2H2. The real time breakthrough gas separation experiments reveal a rarely attempted inverse CO2 selectivity over C2H2, attributed to open metal sites with a perfect pore aperture. This is supported by crystallographic analysis, in situ spectroscopic inspection, and selectivity approximations. In situ DRIFTS measurements and DFT-based theoretical calculations confirm CO2 binding sites are coordinatively unsaturated Ni(ii) and carboxylate oxygen atoms, and highlight the influence of multiple adsorption sites.

Hemophagocytic lymphohistiocytosis complicating septicemic melioidosis: A case report.

Melioidosis is an infectious disease caused by Burkholderia pseudomallei. People infected with B. pseudomallei experience fever and skin changes, pneumonia, abscesses, and septic shock that could cause death. Hemophagocytic lymphohistiocytosis is a severe inflammatory syndrome due to the excess activation of macrophages and T cells. We report a 50-year-old hypertensive and diabetic male patient presented with high-grade intermittent fever with loss of appetite and weight loss for two months and a history of jaundice, backache and swelling of both feet for 15 days. Blood and bone marrow culture grew Burkholderia pseudomallei. A liver biopsy revealed Kupffer cell hyperplasia and hemophagocytosis. The patient was treated with an injection of dexamethasone 4mg intravenous three times a day for five days and tapered over 15 days with ceftazidime 2 gm intravenous three times a day for six weeks. Early suspicion in the diagnosis of hemophagocytic lymphohistiocytosis in septicemia can prevent severe complications, even death.

Microwave Assisted Fast Synthesis of a Donor-Acceptor COF Towards Photooxidative Amidation Catalysis.

The synthesis of covalent organic frameworks (COFs) at bulk scale require robust, straightforward, and cost-effective techniques. However, the traditional solvothermal synthetic methods of COFs suffer low scalability as well as requirement of sensitive reaction environment and multiday reaction time (2-10 days) which greatly restricts their practical application. Here, we report microwave assisted rapid and optimized synthesis of a donor-acceptor (D-A) based highly crystalline COF, TzPm-COF in second (10 sec) to minute (10 min) time scale. With increasing the reaction time from seconds to minutes crystallinity, porosity and morphological changes are observed for TzPm-COF. Owing to visible range light absorption, suitable band alignment, and low exciton binding energy (Eb=64.6 meV), TzPm-COF can efficaciously produce superoxide radical anion (O2⋅-) after activating molecular oxygen (O2) which eventually drives aerobic photooxidative amidation reaction with high recyclability. This photocatalytic approach works well with a variety of substituted aromatic aldehydes having electron-withdrawing or donating groups and cyclic, acyclic, primary or secondary amines with moderate to high yield. Furthermore, catalytic mechanism was established by monitoring the real-time reaction progress through in situ diffuse reflectance infrared Fourier transform spectroscopic (DRIFTS) study.

Hydrogen Evolution in Neutral Media by Differential Intermediate Binding at Charge-Modulated Sites of a Bimetallic Alloy Electrocatalyst.

The energy barrier to dissociate neutral water has been lowered by the differential intermediate binding on the charge-modulated metal centers of Co85Mo15 sheets supported on Ni-foam (NF), where the overpotential for hydrogen evolution reaction (HER) in 1 M phosphate buffer solution (PBS) is only 50±9 mV at -10 mA cm-2. It has a turnover frequency (TOF) of 0.18 s-1, mass activity of 13.2 A g-1 at -200 mV vs. reversible hydrogen electrode (RHE), and produces 16 ml H2 h-1 at -300 mV vs. RHE, more than double that of 20 % Pt/C. The Moδ+ and Coδ- sites adsorb OH*, and H*, respectively, and the electron injection from Co to H-O-H cleaves the O-H bond to form the Mo-OH* intermediate. Operando spectral analyses indicate a weak H-bonded network for facilitating the H2O*/OH* transport, and a potential-induced reversal of the charge density from Co to the more electronegative Mo, because of the electron withdrawing Co-H* and Mo-OH* species. Co85Mo15/NF can also drive the complete electrolysis of neutral water at only 1.73 V (10 mA cm-2). In alkaline, and acidic media, it demonstrates a Pt-like HER activity, accomplishing -1000 mA cm-2 at overpotentials of 161±7, and 175±22 mV, respectively.

COF-Topological Quantum Material Nano-heterostructure for CO2 to Syngas Production under Visible Light.

Efficient solar-driven syngas production (CO+H2 mixture) from CO2 and H2O with a suitable photocatalyst and fundamental understanding of the reaction mechanism are the desired approach towards the carbon recycling process. Herein, we report the design and development of an unique COF-topological quantum material nano-heterostructure, COF@TI with a newly synthesized donor-acceptor based COF and two dimensional (2D) nanosheets of strong topological insulator (TI), PbBi2Te4. The intrinsic robust metallic surfaces of the TI act as electron reservoir, minimising the fast electron-hole recombination process, and the presence of 6s2 lone pairs in Pb2+ and Bi3+ in the TI helps for efficient CO2 binding, which are responsible for boosting overall catalytic activity. In variable ratio of acetonitrile-water (MeCN : H2O) solvent mixture COF@TI produces syngas with different ratios of CO and H2. COF@TI nano-heterostructure enables to produce higher amount of syngas with more controllable ratios of CO and H2 compared to pristine COF. The electron transfer route from COF to TI was realized from Kelvin probe force microscopy (KPFM) analysis, charge density difference calculation, excited state lifetime and photoelectrochemical measurements. Finally, a probable mechanistic pathway has been established after identifying the catalytic sites and reaction intermediates by in situ DRIFTS study and DFT calculation.

Effectiveness of peer-led intervention in control of non-communicable diseases in rural areas of Khordha district: study protocol for a cluster randomized controlled trial.

BACKGROUND: The main contributors to death and disability from chronic illnesses in developing nations are elevated blood pressure (hypertension), blood sugar (diabetes mellitus), and blood cholesterol (dyslipidaemia). Even though there are affordable treatments, the treatment gap for these conditions is still significant. Few pilot studies from industrialized nations discuss the value of peer-led interventions for achieving community-level management of blood pressure and blood sugar. This study aims to evaluate the effectiveness of peer-led intervention compared to standard care in achieving control of selected non-communicable diseases (NCDs) in Indian context at 1 year of intervention among people of 30-60 years with hypertension and/or diabetes mellitus and/or dyslipidaemia. METHODS: A cluster-randomized controlled trial will be conducted in villages of two rural blocks of the Khordha district of Odisha from August 2023 to December 2024. A total of 720 eligible participants (360 in the intervention group and 360 in the control group) will be recruited and randomized into two study arms. The participants in the intervention arm will receive a peer-led intervention model for 6 months in addition to standard care. The sessions will be based on the six domains of NCDs - self-care, follow-up care, medication, physical activity, diet, limiting substance use, mental health and co-morbidities. The mean reduction in blood pressure, HbA1C, and blood cholesterol in the intervention arm compared to the standard care arm will be the main outcome. DISCUSSION: The increasing burden of NCDs demands for newer strategies for management. Peer-led interventions have proven to be useful at the international level. Incorporating it in India will have remarkable results in controlling NCDs. TRIAL REGISTRATION: Clinical Trial Registry of India (CTRI) CTRI/2023/02/050022. Registered on 23 February 2023.

Ovarian mass Presenting as Paraneoplastic cerebellar degeneration with peripheral neuropathy and anti-Yo antibody.

Paraneoplastic neurological syndromes (PNS) are a group of disorders with diverse neurological manifestations that are observed in patients with various types of cancer. Any portion of the nervous system can be affected by these syndromes, which are brought on by processes other than metastasis, direct tumour spread or chemotherapy side effects. An immune-mediated attack on the cerebellar Purkinje cells and consequent cerebellar symptoms define paraneoplastic cerebellar degeneration(PCD), a subtype of the PNS. Axonal or demyelinating paraneoplastic peripheral neuropathies are both possible. Here, we describe the case of a middle-aged woman who presented with subacute-onset cerebellar symptoms and peripheral neuropathy, was discovered to have a positive anti-Yo antibody, and was later detected to have an ovarian mass. This case illustrates the significance of considering a paraneoplastic aetiology in patients with otherwise unexplained neurological manifestations and initiating an appropriate workup and early treatment for the primary malignancy.

Effect of Virgin Coconut Oil (VCO) on Cardiometabolic Parameters in Patients with Dyslipidemia: A Randomized, Add-on Placebo-Controlled Clinical Trial.

OBJECTIVE: Statin monotherapy for dyslipidemia is limited by adverse effects and limited effectiveness in certain subgroups like metabolic syndrome. Add-on therapy with an agent with a known safety profile may improve clinical outcomes, and virgin coconut oil (VCO) may be the candidate agent for improving the cardiometabolic profile. The present study was conducted to evaluate the effect of add-on VCO with atorvastatin in dyslipidemia in adults. METHODS: A randomized, double-blind clinical trial was conducted on 150 patients with dyslipidemia who were randomized into control and test groups. The control group received atorvastatin monotherapy, whereas the test group received add-on VCO with atorvastatin for 8 weeks. At baseline, demographic, clinical, and biochemical parameters were assessed and repeated after 8 weeks of therapy. The main outcome measures were lipid profile, cardiovascular risk indices, 10-year cardiovascular risk, body fat compositions, and thiobarbituric acid reactive substances (TBARS). RESULTS: The increase in HDL in the test group was significantly greater than in the control group (MD: 2.76; 95%CI: 2.43-3.08; p < 0.001). The changes in the atherogenic index (p = 0.003), coronary risk index (p < 0.001), cardiovascular risk index (p = 0.001), and TBARS (p < 0.001) were significantly greater in the test group. The decrease in LDL, total cholesterol and lipoprotein(a), were significantly higher in the control group. There were no significant differences between the groups with respect to the changes in triglyceride, VLDL, and 10-year cardiovascular risk. CONCLUSIONS: Add-on VCO (1000 mg/day) with atorvastatin (10 mg/day) can achieve a better clinical outcome in patients with dyslipidemia by increasing HDL and improving oxidative stress cardiovascular risk indices.

Modular Gating of Ion Transport by Postsynthetic Charge Transfer Complexation in a Metal-Organic Framework.

Nature's design of biological ion channels that demonstrates efficient gating and selectivity brings to light a very promising model to mimic and design for achieving selective and tunable ion transport. Functionalized nanopores that permit modulation of the pore wall charges are a compelling approach to gain control over the ion transport mechanism through the pores. This makes way for employing a noncovalent supramolecular approach for attaining charge reversal of the MOF pore walls using donor-acceptor pairs that can demonstrate strong charge transfer interactions. Herein, robust Zr4+-based mesoporous MOF-808 was postsynthetically modified into an anion-selective nanochannel (MOF-808-MV) by modification with dicationic viologen-based motifs. Charge modulation and even reversal of the MOF-808-MV pore walls were then explored taking advantage of strong charge transfer interactions between the grafted dicationic viologen acceptor moieties and anionic, π-electron-rich donor guest molecules such as pyranine (PYR) and tetrathiafulvalene tetrabenzoic acid (TTF-TA). Tunability of the MOF pore charge from positive to neutral to negative was achieved via simple methodologies such as diffusion control in case of guest molecule like PYR and by pH modulation for pH-responsive guest like TTF-TA. This results in a concomitant modulation in the selectivity of the nanochannel, rendering it from anion-selective to ambipolar to cation-selective. Furthermore, as a real-time application of this ion channel, Na+ ion conductivity (σ = 3.5 × 10-5 S cm-1) was studied at ambient temperature.

Comparison of post contrast fluid attenuated inversion recovery, 3D T1-SPACE, and T1W MRI sequences with fat suppression in the diagnosis of infectious meningitis.

OBJECTIVE: To assess the usefulness of post contrast Fluid attenuated inversion recovery (FLAIR), 3D T1-SPACE, and T1W magnetic resonance imaging (MRI) sequences with fat suppression in diagnosis of infectious meningitis. METHODS: 75 patients with clinical suspicion of meningitis were evaluated with post contrast FLAIR (PC-FLAIR), post contrast T1-SPACE (PC-T1-SPACE), and post contrast T1WI (PC-T1WI). Sensitivity, specificity, positive predictive value, and negative predictive value of individual sequences were assessed. RESULTS: The sensitivity of PC-FLAIR (88.4%) was greater than PC-T1-SPACE (85.5%) and PC-T1WI (82.6%), considering cerebrospinal fluid (CSF) analysis as gold standard (p < 0.05). Kappa inter-rater agreement between two radiologists was 0.921 for PC-T1-SPACE, 0.921 for PC-T1WI, and 1.0 for PC-FLAIR with a p value <0.05. Both PC-T1-SPACE and PC-FLAIR performed equally in sulcal space enhancement. PC-T1-SPACE and PC-T1WI performed better in evaluation of pachymeningeal enhancement, ependymal enhancement in cases of ventriculitis, whereas PC-FLAIR was more sensitive in assessment of basal cistern enhancement and enhancement along the cerebellar folia. CONCLUSION: Meningeal enhancement could be better appreciated in PC-FLAIR image than PC-T1WI and PC-T1-SPACE. Enhancement in PC-T1-SPACE was comparable to that of PC-T1WI. Being a T1 based spin echo sequence, PC-T1-SPACE has all the advantages of PC-T1WI in addition to its ability to differentiate meningeal enhancement from leptomeningeal vessels. Hence, PC-T1WI can be replaced by PC-T1-SPACE and PC-FLAIR can be added to routine MRI protocol in suspected case of meningitis.

Levothyroxine Therapy and Predictors of Cardiovascular Risk in Clinical Hypothyroidism: A Prospective Cohort Study.

Background Hypothyroidism is associated with hypoadiponectinemia, insulin resistance, and increased cardiovascular risk. The association of adiponectin, insulin resistance, and future cardiovascular risk in clinical hypothyroidism and the effect of levothyroxine are non-conclusive because of the contradictory results. The present prospective cohort study has been conducted to evaluate the effect of levothyroxine on serum adiponectin, insulin resistance, and cardiovascular risk in patients with clinical hypothyroidism. Methods Sixty patients with clinical hypothyroidism who were prescribed levothyroxine were recruited following selection criteria and changes in Zulewski's score, glycemic parameters, homeostatic model assessment of insulin resistance (HOMA-IR), quantitative insulin sensitivity check index (QUICKI), lipid profile, serum adiponectin, serum high-sensitivity C-reactive protein (hs-CRP), cardiovascular risk indices, and Framingham risk score were assessed 12 weeks post-levothyroxine therapy. Receiver operating characteristic (ROC) analysis was done to detect the cut-off for adiponectin levels to differentiate between responders and non-responders. Neural network models were created to predict the risk of cardiovascular morbidity. Results Post-levothyroxine therapy, there was a significant improvement in body mass index (BMI) (p = 0.025), diastolic blood pressure (p = 0.021), Zulewski's score (p < 0.001), serum insulin (p = 0.005), fasting sugar (p < 0.001), serum adiponectin (p < 0.001), thyroid profile (p < 0.001), total cholesterol (p < 0.001), low-density lipoprotein (p < 0.001), high-density lipoprotein (p = 0.007), triglycerides (p = 0.002), and subcutaneous fat (p = 0.015). Serum adiponectin showed significant improvement in hypothyroid patients compared to euthyroid individuals (mean difference: -2.21; 95% CI: -2.52 to -1.91; p < 0.001). Mean difference in insulin resistance (HOMA-IR: 0.3, p < 0.001; QUICKI: -0.002, p < 0.001) and cardiovascular risk (atherogenic index: 0.12, p = 0.04; coronary risk index: 0.14, p = 0.038; Framingham risk score: 0.65, p = 0.041) also showed improvement. Serum adiponectin and thyroid-stimulating hormone levels were directly correlated with insulin resistance and cardiovascular risk scores. Conclusion The reduced serum adiponectin level and increased cardiovascular risk in clinical hypothyroidism were improved with hormone replacement, and serum adiponectin level was found to be a good prognostic marker for the treatment response.

Study Protocol: IMPETUS: Implementing a Uniform Stroke Care Pathway in Medical Colleges of India: IMPETUS Stroke.

Introduction: In India, a national program for stroke (national programme for the control of cardiovascular diseases, diabetes, cancer, and stroke) and stroke management guidelines exist. Its successful implementation would need an organized system of stroke care in practice. However, many challenges exist including lack of awareness, prehospital notification systems, stroke ready hospitals, infrastructural weaknesses, and rehabilitation. We present here a protocol to investigate the feasibility and fidelity of implementing a uniform stroke care pathway in medical colleges of India. Methods and Analysis: This is a multicentric, prospective, multiphase, mixed-method, quasi-experimental implementation study intended to examine the changes in a select set of stroke care-related indicators over time within the sites exposed to the same implementation strategy. We shall conduct process evaluation of the implementation process as well as evaluate the effect of the implementation strategy using the interrupted time series design. During implementation phase, education and training about standard stroke care pathway will be provided to all stakeholders of implementing sites. Patient-level outcomes in the form of modified Rankin Scale score will be collected for all consecutive patients throughout the study. Process evaluation outcomes will be collected and reported in the form of various stroke care indicators. We will report level and trend changes in various indicators during the three study phases. Discussion: Acute stroke requires timely detection, management, and secondary prevention. Implementation of the uniform stroke care pathway is a unique opportunity to promote the requirements of homogenous stroke care in medical colleges of India.

Vascular Manifestations of Tuberculous Meningitis: MR Angiography and Venography Study.

Purpose The purpose of this study is to evaluate magnetic resonance (MR) angiography (MRA) and venography (MRV) findings in tuberculous meningitis (TBM). Methods Thirty consecutive patients of clinically diagnosed TBM were enrolled. Apart from T2-weighted imaging, T1-weighted imaging (T1WI), diffusion-weighted imaging, susceptibility-weighted imaging, fluid-attenuated inversion recovery, and postcontrast T1WI, time-of-flight (TOF) MRA and postcontrast MRV were done in all the patients. MRV was done after intravenous administration of gadolinium-based contrast agent followed by postcontrast T1WI. MRA and MRV findings were analyzed. Results Mean age of the patients was 33.13 ± 14.93 years. Duration of symptom was 34.90 ± 33.82 (range: 10-150) days. Out of 30 patients, 11 were categorized as definite TBM and 19 probable TBM. Eighteen (60%) were grade I, 7 (23%) grade II, and 5 (16%) grade III TBM based on severity. MR abnormalities were in varying combinations of leptomeningeal enhancement in 24 (80%), pachymeningeal in 2, both in 3, tuberculomas in 13 (43.3%), ventriculitis in 1, hydrocephalus in 16 (53.3%), and infarcts in 10 (33.3%) patients out of which the tubercular zone infarct in 9 patients. TOF MRA showed arterial abnormality in 13 patients. Anterior cerebral artery and middle cerebral artery have commonly involved vessels. Dural sinus thrombosis was noted in two patients. Both were female. One patient had subacute thrombus in the posterior part of superior sagittal sinus, left transverse sinus, and proximal right transverse sinus. The second patient had a filling defect in the transverse sinus. Conclusion In TBM, there is predominant arterial involvement causing infarcts which are usually seen in the tubercular zone. However, occasionally, there may be venous involvement causing cerebral venous sinus thrombosis.

Self-reported survey on infection prevention and control structures in healthcare facilities part of a national level healthcare associated infection surveillance network in India, 2019.

BACKGROUND: Healthcare associated infections (HAIs) are prevalent and difficult to treat worldwide. Most HAIs can be prevented by effective implementation of Infection Prevention and Control (IPC) measures. A survey was conducted to assess the existing IPC practices across a network of Indian Hospitals using the World Health Organization designed self-assessment IPC Assessment Framework (IPCAF) tool. METHODS: This was a cross sectional observation study. Thirty-two tertiary care public and private facilities, part of the existing Indian HAI surveillance network was included. Data collected was analyzed by a central team at All India Institute of Medical Sciences, New Delhi, a tertiary care hospital of India. The WHO questionnaire tool was used to understand the capacity and efforts to implement IPC practices across the network. RESULTS: The overall median score of IPCAF across the network was 620. Based on the final IPCAF score of the facilities; 13% hospitals had basic IPC practices, 28% hospitals had intermediate and 59% hospitals had advanced IPC practices. The component multimodal strategies had the broadest range of score while the component IPC guidelines had the narrowest one. CONCLUSIONS: Quality improvement training for IPC nurses and healthcare professionals are needed to be provided to health facilities.

Myelin oligodendrocyte glycoprotein (MOG) antibody-associated longitudinally extensive transverse myelitis (LETM) and primary Sjogren syndrome: a rare association.

Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) is a recent addition to the field of central nervous system inflammatory disorders. It can have a wide range of presentations, including optic neuritis, transverse myelitis, acute disseminated encephalomyelitis or any combination of these. The aquaporin-4-positive neuromyelitis optica (NMO) is a close differential owing to the similar clinical presentation. There is a proven association between NMO and autoimmunity, whereas such an association is yet to be established in the case of MOGAD. Here we describe the case of a woman in her 30s presenting with sudden-onset quadriparesis with sensory and autonomic involvement who was diagnosed with MOGAD (cervicothoracic longitudinally extensive transverse myelitis) and found to have primary Sjogren syndrome on further workup. This association between MOGAD and autoimmunity should be kept in mind, as diagnosis of the former should alert the physician to the possibility of the latter's existence and the need to initiate an appropriate workup.

Emergent Bistable Switches from the Incoherent Feed-Forward Signaling of a Positive Feedback Loop.

Bistability is intrinsically connected to various decision making processes in living systems. The operating principles of a bistable switch, generated from a positive feedback loop, are well understood both in natural and synthetic settings. However, the fate of dynamic modularity of a positive feedback loop is unknown when it is connected to another dynamically modular signaling motif. In order to address this, here we investigate feed-forward signaling of a positive feedback loop to determine the fate of a bistable switch under such signaling. Using the potential energy based high-throughput bifurcation analysis method, we uncover that in addition to the conventional bistability the hybrid motifs generate various emergent bistable switches, namely mushroom and isola switches, which are not produced by the individual motifs. Using random parameter sampling, network perturbation, and phase plane analysis, we establish the design principles of such emergent behaviors. Incoherent feed-forward signaling of a positive feedback loop with distinct regulatory thresholds of the two arms of the feed-forward loop are the key requirements for such emergent behaviors. Our calculations show that the specific types of atypical bistable responses depend on the logic gate configuration of the signals. However, the emergent bistable behaviors of the hybrid networks do not depend on the nature of the positive feedback loop.

Potential Landscapes, Bifurcations, and Robustness of Tristable Networks.

Bistable switches that produce all-or-none responses have been found to regulate a number of natural cellular decision making processes, and subsequently synthetic switches were designed to exploit their potential. However, an increasing number of studies, particularly in the context of cellular differentiation, highlight the existence of a mixed state that can be explained by tristable switches. The criterion for designing robust tristable switches still remains to be understood from the perspective of network topology. To address such a question, we calculated the robustness of several 2- and 3-component network motifs, connected via only two positive feedback loops, in generating tristable signal response curves. By calculating the effective potential landscape and following its modifications with the bifurcation parameter, we constructed one-parameter bifurcation diagrams of these models in a high-throughput manner for a large combinations of parameters. We report here that introduction of a self-activatory positive feedback loop, directly or indirectly, into a mutual inhibition loop leads to generating the most robust tristable response. The high-throughput approach of our method further allowed us to determine the robustness of four types of tristable responses that originate from the relative locations of four bifurcation points. Using the method, we also analyzed the role of additional mutual inhibition loops in stabilizing the mixed state.

Eosinophilic Ascites: A Rare Case Report With Diagnostic and Therapeutic Challenges.

Eosinophilic ascites is a manifestation of serosal eosinophilic gastrointestinal disease. We present a 44-year-old male with low serum ascites albumin gradient with high eosinophil count and contrast-enhanced computed tomography of the abdomen showing circumferential wall thickening of the esophagus, mid to distal ileal loops, and ascending colon. The patient was managed with tablet prednisolone 20 mg twice daily for two weeks, then gradual tapering over one month. The patient responded to treatment. Awareness of the condition, timely diagnosis, and early treatment carries excellent responses.

Aluminium Phosphide Poisoning: Early Suspicion of Cardiotoxicity Is Necessary for Improved Outcomes.

Poisoning is one of the more conventional modes of suicide in some parts of India. Aluminium phosphide (ALP) is a chemical used for this purpose and manifests severe cardiovascular complications, such as hypotension, shock, various arrhythmias, congestive heart failure with toxic myocarditis, and in rare cases, ST-segment elevation myocardial infarction or other electrocardiogram changes. Upon contact with moisture, ALP yields phosphine gas, a toxic systemic poison found in pesticides that can lead to cardiovascular-related mortality. We present a case of ALP poisoning in a 60-year-old woman who was asymptomatic for the first 48 hours. She gradually developed cardiac complications in the form of anteroseptal acute myocardial infarction (AMI). As AMI is very rare among the various cardiac complications, an early vigilance is necessary to prevent further complications in ALP poisoning.